Janet Fox doesn’t remember how she was able to get up when she fell in front of her house a while back.

She had just returned home from a successful visit with a cousin. She was happy for the uneventful drive out and back, but that optimism crashed down when she fell and landed in the gutter.

The 85-year-old from Dallastown said she has bad knees, so she can’t imagine how she could have propped herself up to stand unassisted.

What she does remember is the embarrassment.

She recalls how she didn't want her neighbors to see her. Maybe, she thought, that's how she managed to get up so quickly, motivated to move before anyone saw her.

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From the left, Claudia Besecker, 66, of Spring Garden Township and Vicky Charley, 67, of Dover Township, do some warm-up exercises during a Matter of Balance class in York Township.(Photo: Paul Kuehnel, York Daily Record)

That embarrassment is what keeps many seniors from telling their children or even their doctor about a fall.

Yet falling and not reporting it to medical professionals can be deadly.

In 2018, falls were the leading cause of death for people age 55 and over among deaths reported to the York County Coroner’s Office, according to the coroner’s annual report.

The deaths of 98 people age 55 and older in the county were attributed to falls, the report states. It's consistently the biggest cause of deaths for local seniors.

And the numbers are always skewed.

“We do know that fall deaths are underreported across the country,” Coroner Pam Gay said by email. “In our office, we are constantly educating physicians, nurses and others in local health care facilities about the importance of reporting these deaths to our office, but sometimes, they still get missed.”

“And we catch some of these fall deaths that way,” Gay said. But, she added, many people are buried, and if the doctor, family or funeral home doesn’t note that a fall led to the death, the coroner’s office isn’t typically involved, and those deaths go unreported.

Gay thinks it’s likely that the improved awareness about fall deaths needing to be reported to her office is contributing to the increase in fall deaths year over year.

From the left, Claudia Besecker, 66, of Spring Garden Township and Vicky Charley, 67, of Dover Township, do some warm-up exercises during a Matter of Balance class in York Township. Paul Kuehnel, York Daily Record

Seniors look over an animated worksheet about hazards that they could experience in their home during a Matter of Balance class in York Township Monday February 25, 2019. Paul Kuehnel, York Daily Record

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There has been a steady increase in home/play deaths in York County, which is the category that includes deaths from falls. In 2018, 98 of the 128 home/play deaths were from falls.

But even though the reason for the increase could be attributed somewhat to an increased reporting, the reality is that older adults in York County are dying from something largely preventable.

Fox, the Dallastown woman who fell in front of her house, has fallen on a number occasions.

“I’ve broken bones,” she said.

She doesn’t want to be a statistic or suffer a fall that steals her independence. Right now, her children stop in to care for her occasionally, doing things like bringing items down from high shelves. She still drives and is able to take care of much of her day-to-day life without assistance.

But falling once can create a fear of falling for many seniors. That fear can become a self-fulfilling prophecy, said Megan Craley, health and wellness coordinator with the York County Area Agency on Aging. Yet it’s possible to work through that fear.

The agency has a number of programs available to seniors, many of them free, that include education on fall prevention. Some are hours long, and some of them happen over many weeks.

One, A Matter of Balance, is where Fox found herself talking about her fear of falling and how she is trying to work through that and take steps to prevent falls.

She was one of four participants in a recent class. Fox’s class meets for about two hours each Monday afternoon for eight weeks.

Led by two coaches, the class goes through a series of light exercises, most done sitting in a chair and others done standing with a chair in front of them to hold on for balance if needed, before moving on to instruction.

During the recent class, participants reviewed their homework assignment: An at-home checklist of some fall hazards around their house, like frayed rugs, cords in areas where they walk, adequate lighting, etc.

Coaches Linda Topper and Barb Walker led the class through their checklists, discussing ways to tend to some hazards, and then Topper talked about what they can do in the event they do fall.

First, keep calm and get your bearings, Topper said. Then, work to get yourself to something sturdy so you can get up off the floor.

If you've hit your head, Topper said, "you need to call the doctor."

A subdural hematoma, or a brain bleed, can show no symptoms. It can be deadly. Fortunately, doctors can send you for a test to see if you have a brain bleed. But pride can get in the way of many people seeking medical attention.

Craley, with the agency on aging, said some seniors are afraid that if they report they've fallen, their children or other caretakers will reduce their independence and mobility.

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Seniors stretch their arms out and flex their wrists during a Matter of Balance class.(Photo: Paul Kuehnel, York Daily Record)

"Falls are the No. 1 reason they lose their independence," Craley said.

In reality, someone who has fallen probably needs to remain just as active as they were or they might even need to become more active to build up their strength and to show themselves they don't have to be afraid to fall again.

Topper, one of the A Matter of Balance coaches, said most falls occur in the home. That statistic rings true among deaths that resulted from falls in York County in 2018.

Limiting someone's mobility could keep them from leaving home, and if there are hazards in the home, that person might not be any more safe staying put.

Topper, Walker and Craley agreed that seniors need to keep moving.

Many insurance companies have fitness program offerings for seniors, and the agency on aging has resources it can offer for seniors interested in getting more active. Activity doesn't have to happen outside of the home, though, Craley said.

"They don't have to go to the gym," she said. Simple exercises, like those being done by the group in the class, including sitting and standing, rotating your ankles, raising your arms over your head, can all improve strength and get your blood pumping.

Craley said she knows that accidents happen, and it's probably impossible to prevent all falls. But seeing falls be the No. 1 cause of traumatic death to seniors in York County again in 2018 is sad.

"It is tragic because falls are preventable," she said.

She hopes that more people will learn about the services the agency on aging offers, including the A Matter of Balance class. To get more information about those services visit www.fallsfreeyork.org.

Second annual diabetes expo planned

The Diabetes Coalition of York County will host the second annual diabetes expo at Penn State York, 1031 Edgecomb Ave., from 9 a.m. to 3 p.m. March 23. The free event is for people who have been diagosed with diabetes or who are at risk for diabetes, and their family members.

There will be free glucose, cholesterol, BMI, A1C and balance testing. For more information, call Amber at 717-456-0565 or email ykdiabetescoalition@gmail.com.

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Steve Miller, 56, of Spring Grove, Joyce DiGiacinto, 73, of Airville and Rich Helfrich, 78, of Emigsville, break out of their starting positions in the 400-meter relay at the York County Senior Games Wednesday, June 20, 2018 at Central York High School. Jim Seip, York Daily Record

Charlotte Grove of York Township, left, wraps her arm around Connie Crull of Yoe as they share a laugh during shuffleboard at the York County Senior Games Wednesday, June 20, 2018 at Central York High School. Jim Seip, York Daily Record

Jeff Brown, 55, of York finishes the anchor leg of the 4x100 relay, helping his team win the event at the York County Senior Games Wednesday, June 20, 2018 at Central York High School. Jim Seip, York Daily Record